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Nian YY, Meng XM, Wu J, Jing FC, Wang XQ, Dang T, Zhang J. Postprandial proximal gastric acid pocket and its association with gastroesophageal acid reflux in patients with short-segment Barrett's esophagus. J Zhejiang Univ Sci B 2020; 21:581-589. [PMID: 32633112 PMCID: PMC7383323 DOI: 10.1631/jzus.b1900498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/15/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the characteristics of postprandial proximal gastric acid pockets (PPGAPs) and their association with gastroesophageal acid reflux in patients with Barrett's esophagus (BE). METHODS Fifteen patients with BE (defined by columnar lined esophagus of ≥1 cm) and 15 healthy individuals that were matched for age, gender, and body mass index, were recruited. The fasting intragastric pH and the appearance time, length, lowest pH, and mean pH of the PPGAP were determined using a single pH electrode pull-through experiment. For BE patients, a gastroesophageal reflux disease questionnaire (GerdQ) was completed and esophageal 24-h pH monitoring was carried out. RESULTS The PPGAP was significantly longer (5 (3, 5) cm vs. 2 (1, 2) cm) and the lowest pH (1.1 (0.8, 1.5) vs. 1.6 (1.4, 1.9)) was significantly lower in patients with short-segment BE than in healthy individuals. The PPGAP started to appear proximally from the gastroesophageal pH step-up point to the esophageal lumen. The acidity of the PPGAP was higher in the distal segment than in the proximal segment. In short-segment BE patients, there were significant correlations between the acidity and the appearance time and length of the PPGAP. The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes. The acidity of the PPGAP was associated with the DeMeester scores, the GerdQ scores, and the fasting intragastric pH. CONCLUSIONS In patients with short-segment BE, a PPGAP is commonly seen. Its length and acidity of PPGAP are associated with gastroesophageal acid reflux, the DeMeester score, and the GerdQ score in patients with short-segment BE.
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Affiliation(s)
- Yuan-yuan Nian
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014040, China
| | - Xian-mei Meng
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014040, China
- †E-mail:
| | - Jing Wu
- Department of Gastroenterology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710049, China
| | - Fu-chu Jing
- Department of Gastroenterology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710049, China
| | - Xue-qin Wang
- Department of Gastroenterology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710049, China
| | - Tong Dang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014040, China
| | - Jun Zhang
- Department of Gastroenterology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710049, China
- †E-mail:
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Zhou H, Yang L, Xu X, Lu M, Guo R, Li D, Huang Q, Liu Y, Deng G, Xu Y. miR-34a inhibits esophageal squamous cell carcinoma progression via regulation of FOXM1. Oncol Lett 2018; 17:706-712. [PMID: 30655820 DOI: 10.3892/ol.2018.9593] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 09/26/2018] [Indexed: 01/02/2023] Open
Abstract
Downregulation of microRNA-34a (miR-34a) has frequently been observed in esophageal squamous cell carcinoma (ESCC). However, the underlying role and molecular mechanism of miR-34a in ESCC remains largely unknown. In the current study, it was demonstrated that miR-34a was downregulated and forkhead box M1 (FOXM1), a target gene of miR-34a, was upregulated in ESCC tumor tissues. Overexpression of miR-34a decreased FOXM1 mRNA and protein expression in the ESCC cell lines tested (TE-1 and TE-8). Inhibition of miR-34a increased FOXM1 mRNA and protein levels in human esophageal epithelial cells (HEEC). In addition, miR-34a mimics reduced the relative luciferase activity of ESCC cells transfected with FOXM1 3'UTR-WT, but not FOXM1 3'UTR-Mut. The CCK8 assay and scratch wound healing assay showed that overexpression of miR-34a induced inhibition of cell proliferation and cell migration. Additionally, transfection with miR-34a mimics reduced the expression of key genes involved in cell migration (MMP2 and MMP9) in ESCC cells. Thus, the present data demonstrated that miR-34a suppressed ESCC progression by directly targeting FOXM1.
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Affiliation(s)
- Haibo Zhou
- Institute of Oncology, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Li Yang
- Department of Thyroid and Breast, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Xinhua Xu
- Institute of Oncology, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Mingqian Lu
- Institute of Oncology, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Rong Guo
- Institute of Oncology, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Daojun Li
- Institute of Oncology, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Qiao Huang
- Institute of Oncology, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Yang Liu
- Institute of Oncology, The First College of Clinical Medical Science, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang, Hubei 443000, P.R. China
| | - Glenn Deng
- School of Medicine, Stanford University, Stanford, CA 94305, USA.,Advanced Gene Diagnostics, Inc. Tsinghua Science Park, Yichang, Hubei 443001, P.R. China
| | - Yalin Xu
- Department of Clinical Laboratory, Chibi Pu Spinning Hospital, Chibi, Hubei 437321, P.R. China
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Different Genotype of rs3130932 Single Nucleotide Polymorphism Between Gastric Cancer Patients and Normal Subjects. J Gastrointest Cancer 2017; 48:38-41. [PMID: 27573011 DOI: 10.1007/s12029-016-9869-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Octamer binding transcription factor B gene (OCT4) is responsible for development and self-renewal maintenance of embryonic stem cells. The rs3130932 single nucleotide polymorphism (SNP) may play a role in tumor genesis. Because of high prevalence of gastric cancer in north of Iran, this study was investigated role of rs3130932 polymorphism and stomach cancer. METHODS Blood samples were collected from 100 informed gastric cancer patients and 100 age and sex-matched healthy individuals, and were genotyped for the presence of rs3130932G allele by ssp PCR. RESULTS The mean age of participant (n = 200) was 67.83 ± 10.878 years. In genotyping and allelic analysis, TG genotype increased 66.147 times more likely to develop stomach cancer than the TT genotype, and disease risk increases 140.496 times more in GG genotype in comparison with TT genotype. CONCLUSION This study clearly emphasis on different genetic profile in this population and show that the rs3130932G allele and odds of gastric cancer are related to each other in northern of Iran.
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Hemmatzadeh M, Mohammadi H, Karimi M, Musavishenas MH, Baradaran B. Differential role of microRNAs in the pathogenesis and treatment of Esophageal cancer. Biomed Pharmacother 2016; 82:509-19. [PMID: 27470391 DOI: 10.1016/j.biopha.2016.05.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/06/2016] [Accepted: 05/09/2016] [Indexed: 12/22/2022] Open
Abstract
Esophageal cancer (EC) is the most invasive disease associated with inclusive poor prognosis. EC usually is found as either adenocarcinoma (EAC) or squamous cell carcinomas (ESCC). ESCC forms in squamous cells and highly occurs in the upper third of the esophagus. EAC appears in glandular cells and ordinarily develops in the lower one third of the esophagus near the stomach. Barrett's esophagus (BE) is a metaplastic precursor of EAC. There is a persistent need for improving our understanding of the molecular basis of this disease. MicroRNAs (miRNAs) demonstrate an uncovered class of small, non-coding RNAs that can negatively regulate the protein coding gene, and are associated with approximately all known physiological and pathological processes, especially cancer. MiRNAs can affect cancer pathogenesis, playing a crucial role as either oncogenes or tumor suppressors. The recent emergence of observations on the role of miRNAs in cancer and their functions has induced many investigations to examine their relevance to esophageal cancer. In esophageal cancer, miRNA dysregulation plays a crucial role in cancer prognosis and in patients' responsiveness to neo-adjuvant and adjuvant therapies. In this review, the oncogenic, tumor suppressive, and drug resistance related roles of miRNAs, and their involvement in the pathogenesis and treatment of esophageal cancer were summarized.
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Affiliation(s)
- Maryam Hemmatzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Tabriz University of Medical Sciences, International Branch (Aras), Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Mohammadi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Karimi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Tabriz University of Medical Sciences, International Branch (Aras), Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Musavishenas
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Tabriz University of Medical Sciences, International Branch (Aras), Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Flatulence awareness among the masses and its affinity with daily foods along with anti-ulcerant drugs in Bangladesh. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2016. [DOI: 10.1016/s2222-1808(15)61052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zhou P, Sun L, Liu D, Liu C, Sun L. Long Non-Coding RNA lincRNA-ROR Promotes the Progression of Colon Cancer and Holds Prognostic Value by Associating with miR-145. Pathol Oncol Res 2016; 22:733-40. [PMID: 27071407 DOI: 10.1007/s12253-016-0061-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/06/2016] [Indexed: 12/24/2022]
Abstract
Large intergenic non-coding RNA ribonucleic acids-ROR (lincRNA-ROR) has been reported to exert impacts on the maintenance of induced pluripotent stem cells and embryonic stem cells, and play important roles in human hepatocellular cancer. It contributes to tumorigenesis and metastasis and functions as a competing endogenous RNA (ceRNA) by sponging miR-145 in breast cancer. However, its clinical significance and prognostic value in colon cancer remain unknown. The aim of the present study was to clarify the clinicopathological role and prognostic value of lincRNA-ROR and miR-145 in colon cancer. In the present study, qRT-PCR was performed to measure the expression levels of lincRNA-ROR in colon cancer tissues and cell lines. Then, the clinicopathological significance and prognostic value of lincRNA-ROR were analyzed. LincRNA-ROR expression correlated with pT stage, pN stage, AJCC stage and vascular invasion. Knockdown of lincRNA-ROR restored the expression of miR-145, and had a significant influence on colon cancer cell proliferation, migration and invasion. Patients of the high lincRNA-ROR/low miR-145 group had significantly poorer outcomes than those of the low lincRNA-ROR/high miR-145 group. Taken together, Overexpression of lincRNA-ROR combined with depletion of miR-145 may exert crucial impact on colon cancer prognosis evaluation and treatment.
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Affiliation(s)
- Peng Zhou
- Department of General Surgery, The Second People's Hospital of Wuhu, 259 Jiuhua Middle Road, Wuhu, 241000, China.
| | - Lixia Sun
- Department of General Surgery, The Second People's Hospital of Wuhu, 259 Jiuhua Middle Road, Wuhu, 241000, China
| | - Danfeng Liu
- Department of General Surgery, The Second People's Hospital of Wuhu, 259 Jiuhua Middle Road, Wuhu, 241000, China
| | - Changkuo Liu
- Department of General Surgery, The Second People's Hospital of Wuhu, 259 Jiuhua Middle Road, Wuhu, 241000, China
| | - Lei Sun
- Department of General Surgery, The Second People's Hospital of Wuhu, 259 Jiuhua Middle Road, Wuhu, 241000, China
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7
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Palles C, Chegwidden L, Li X, Findlay JM, Farnham G, Castro Giner F, Peppelenbosch MP, Kovac M, Adams CL, Prenen H, Briggs S, Harrison R, Sanders S, MacDonald D, Haigh C, Tucker A, Love S, Nanji M, deCaestecker J, Ferry D, Rathbone B, Hapeshi J, Barr H, Moayyedi P, Watson P, Zietek B, Maroo N, Gay L, Underwood T, Boulter L, McMurtry H, Monk D, Patel P, Ragunath K, Al Dulaimi D, Murray I, Koss K, Veitch A, Trudgill N, Nwokolo C, Rembacken B, Atherfold P, Green E, Ang Y, Kuipers EJ, Chow W, Paterson S, Kadri S, Beales I, Grimley C, Mullins P, Beckett C, Farrant M, Dixon A, Kelly S, Johnson M, Wajed S, Dhar A, Sawyer E, Roylance R, Onstad L, Gammon MD, Corley DA, Shaheen NJ, Bird NC, Hardie LJ, Reid BJ, Ye W, Liu G, Romero Y, Bernstein L, Wu AH, Casson AG, Fitzgerald R, Whiteman DC, Risch HA, Levine DM, Vaughan TL, Verhaar AP, van den Brande J, Toxopeus EL, Spaander MC, Wijnhoven BPL, van der Laan LJW, Krishnadath K, Wijmenga C, Trynka G, McManus R, Reynolds JV, O'Sullivan J, MacMathuna P, McGarrigle SA, Kelleher D, Vermeire S, Cleynen I, Bisschops R, Tomlinson I, Jankowski J. Polymorphisms near TBX5 and GDF7 are associated with increased risk for Barrett's esophagus. Gastroenterology 2015; 148:367-78. [PMID: 25447851 PMCID: PMC4315134 DOI: 10.1053/j.gastro.2014.10.041] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 10/19/2014] [Accepted: 10/21/2014] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subsequently, the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) identified risk loci for BE and esophageal adenocarcinoma near CRTC1 and BARX1, and within 100 kb of FOXP1. We aimed to identify further SNPs that increased BE risk and to validate previously reported associations. METHODS We performed a genome-wide association study (GWAS) to identify variants associated with BE and further analyzed promising variants identified by BEACON by genotyping 10,158 patients with BE and 21,062 controls. RESULTS We identified 2 SNPs not previously associated with BE: rs3072 (2p24.1; odds ratio [OR] = 1.14; 95% CI: 1.09-1.18; P = 1.8 × 10(-11)) and rs2701108 (12q24.21; OR = 0.90; 95% CI: 0.86-0.93; P = 7.5 × 10(-9)). The closest protein-coding genes were respectively GDF7 (rs3072), which encodes a ligand in the bone morphogenetic protein pathway, and TBX5 (rs2701108), which encodes a transcription factor that regulates esophageal and cardiac development. Our data also supported in BE cases 3 risk SNPs identified by BEACON (rs2687201, rs11789015, and rs10423674). Meta-analysis of all data identified another SNP associated with BE and esophageal adenocarcinoma: rs3784262, within ALDH1A2 (OR = 0.90; 95% CI: 0.87-0.93; P = 3.72 × 10(-9)). CONCLUSIONS We identified 2 loci associated with risk of BE and provided data to support a further locus. The genes we found to be associated with risk for BE encode transcription factors involved in thoracic, diaphragmatic, and esophageal development or proteins involved in the inflammatory response.
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Affiliation(s)
- Claire Palles
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
| | - Laura Chegwidden
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, Devon, UK
| | - Xinzhong Li
- Centre of Biostatistics, Bioinformatics and Biomarkers, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, UK
| | - John M Findlay
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Garry Farnham
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, Devon, UK
| | | | - Maikel P Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Michal Kovac
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Claire L Adams
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, Devon, UK
| | - Hans Prenen
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Sarah Briggs
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Rebecca Harrison
- Department of Pathology, Leicester Royal Infirmary, Leicester, UK
| | - Scott Sanders
- Department of Cellular Pathology, Warwick Hospital, Warwick, UK
| | - David MacDonald
- Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Haigh
- Department of Gastroenterology, Wansbeck General Hospital, Ashington, Northumberland, UK
| | - Art Tucker
- William Harvey Research Institute, The Ernest Cooke Vascular & Microvascular Unit, Centre for Clinical Pharmacology, St Bartholomew's Hospital, London, UK
| | - Sharon Love
- Centre for Statistics in Medicine and Oxford Clinical Trials Research Unit, Oxford, UK
| | - Manoj Nanji
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - John deCaestecker
- Department of Gastroenterology, Leicester General Hospital, Leicester, UK
| | - David Ferry
- Department of Oncology, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Barrie Rathbone
- Department for Gastroenterology, Leicester Royal Infirmary, Leicester, UK
| | - Julie Hapeshi
- Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK
| | - Hugh Barr
- Department of Upper GI Surgery, Gloucestershire, Royal Hospital, Gloucester, UK
| | - Paul Moayyedi
- Department of Medicine, McMaster HC, Hamilton Ontario, Canada
| | - Peter Watson
- School of Medicine, Dentistry, and Biomedical Sciences, Centre for Public Health, Queens University Belfast, NI
| | - Barbara Zietek
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - Neera Maroo
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - Laura Gay
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - Tim Underwood
- University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Lisa Boulter
- University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Hugh McMurtry
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Lancashire, UK
| | - David Monk
- General Surgery, Countess of Chester Hospital, Chester, UK
| | - Praful Patel
- Southampton University Hospitals NHS Trust, Southampton, UK
| | - Krish Ragunath
- Wolfson Digestive Diseases Centre, Queens Medical Centre, Nottingham, UK
| | - David Al Dulaimi
- Worcestershire Acute Hospitals NHS Trust, Alexandra Hospital, Redditch, UK
| | - Iain Murray
- Department of Gastroenterology, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Konrad Koss
- Macclesfield General Hospital, Macclefield, Cheshire, UK
| | - Andrew Veitch
- Department of Oncology, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Nigel Trudgill
- Department of Gastroenterology, Sandwell General Hospital, Lyndon, West Bromwich, UK
| | - Chuka Nwokolo
- Department of Gastroenterology, University Hospital of Coventry, Coventry, UK
| | - Bjorn Rembacken
- Department of Gastroenterology, Leeds General Infirmary, Leeds, UK
| | - Paul Atherfold
- Department of Clinical Pharmacology University of Oxford, Oxford, UK
| | - Elaine Green
- School of Biomedical & Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Yeng Ang
- Gastroenterology, Royal Albert Edward Infirmary NHS Trust, Wigan, UK; GI Science Centre, Salford Royal NHS Foundation Trust, University of Manchester, Salford, UK
| | - Ernst J Kuipers
- Department of Gastroenterology and Hepatology, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Wu Chow
- Forth Valley Royal Hospital, Larbert, Scotland, UK
| | - Stuart Paterson
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norfolk and Norwich University Hospital, Norwich, UK
| | - Sudarshan Kadri
- Department for Gastroenterology, Leicester Royal Infirmary, Leicester, UK
| | - Ian Beales
- Burnley General Hospital, Burnley, Lancashire, UK
| | - Charles Grimley
- Head of Gastroenterology, University Hospital of Northern BC, Prince George, British Columbia, Canada
| | - Paul Mullins
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
| | - Conrad Beckett
- Royal United Hospital Bath NHS Trust, Royal United Hospital, Avon, Bath, Somerset, UK
| | - Mark Farrant
- Kettering General Hospital NHS Foundation Trust, Kettering General Hospital, Rothwell Road, Kettering, Northants, UK
| | - Andrew Dixon
- York Teaching Hospital NHS Foundation Trust, York, UK
| | - Sean Kelly
- Luton and Dunstable University Hospital NHS Foundation Trust, Luton, Bedfordshire, UK
| | - Matthew Johnson
- Department of Thoracic and Upper Gastrointestinal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Shahjehan Wajed
- County and Durham and Darlington NHS Foundation Trust, Bishop Auckland, County Durham, UK
| | - Anjan Dhar
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Elinor Sawyer
- Barts Cancer Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Rebecca Roylance
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Centre, Seattle, Washington
| | - Lynn Onstad
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina
| | - Marilie D Gammon
- Division of Research and San Francisco Medical Center, Kaiser Permanente Northern California, California
| | - Douglas A Corley
- Division of Gastroenterology and Hepatology, UNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | | | - Nigel C Bird
- Division of Epidemiology, University of Leeds, Leeds, UK
| | - Laura J Hardie
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Brian J Reid
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Weimin Ye
- Princess Margaret Cancer Centre, Ontario Cancer Institute, Toronto, ON, Canada
| | - Geoffrey Liu
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Yvonne Romero
- Registry, On behalf of the Romero; Department of Population Sciences, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, California
| | - Leslie Bernstein
- Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California
| | - Anna H Wu
- Department of Surgery, University of Saskatchewan, Saskatoon, Canada
| | - Alan G Casson
- MRC Cancer Cell Unit, Hutchison-MRC Research Centre and University of Cambridge, Cambridge, UK
| | - Rebecca Fitzgerald
- Cancer Control, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - David C Whiteman
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Harvey A Risch
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - David M Levine
- Department of Gastroenterology, Tergooi Hospital, Hilversum, The Netherlands
| | - Tom L Vaughan
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina
| | - Auke P Verhaar
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jan van den Brande
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Eelke L Toxopeus
- Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Manon C Spaander
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Bas P L Wijnhoven
- Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Luc J W van der Laan
- Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Kausilia Krishnadath
- Department of Genetics, University Medical Centre Groningen and University of Groningen, The Netherlands
| | - Cisca Wijmenga
- Department of Clinical Medicine & Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin, Ireland
| | - Gosia Trynka
- Department of Clinical Medicine & Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin, Ireland
| | - Ross McManus
- Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin, St. James' Hospital, Dublin, Ireland
| | - John V Reynolds
- Gastrointestinal Unit, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
| | - Jacintha O'Sullivan
- Gastrointestinal Unit, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
| | - Padraic MacMathuna
- Faculty of Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Sarah A McGarrigle
- Gastrointestinal Unit, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
| | - Dermot Kelleher
- Faculty of Medicine, Imperial College, South Kensington Campus, London, UK
| | - Severine Vermeire
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Isabelle Cleynen
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Raf Bisschops
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Ian Tomlinson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
| | - Janusz Jankowski
- University Hospitals Coventry & Warwickshire NHS Trust, Warwickshire, England; Warwick Medical School, University of Warwick, Warwickshire, England.
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Fouad YM, Mostafa I, Yehia R, El-Khayat H. Biomarkers of Barrett's esophagus. World J Gastrointest Pathophysiol 2014; 5:450-456. [PMID: 25400988 PMCID: PMC4231509 DOI: 10.4291/wjgp.v5.i4.450] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 07/02/2014] [Accepted: 07/17/2014] [Indexed: 02/06/2023] Open
Abstract
Barrett’s esophagus is the strongest risk for esophageal adenocarcinoma (EAC). Metaplasia in patients with BE may progress to dysplasia and then invasive carcinoma. Well-defined diagnostic, progressive, predictive, and prognostic biomarkers are needed to identify the presence of the disease, estimate the risk of malignant transformation, and predict the therapeutic outcome and survival of EAC patients. There are many predictive and prognostic markers that lack substantial validation, and do not allow stratification of patients with gastroesophageal reflux disease in clinical practice for outcome and effectiveness of therapy. In this short review we summarize the current knowledge regarding possible biomarkers, focusing on the pathophysiologic mechanisms to improve prognostic and therapeutic approaches.
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9
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Xiaohua Y, Zhenjiang Y, Weidong L, Pengcheng X, Sidong C. The non-linear threshold association between aspirin use and esophageal adenocarcinoma: results of a dose-response meta-analysis. Pharmacoepidemiol Drug Saf 2014; 23:278-84. [PMID: 24436316 DOI: 10.1002/pds.3560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 11/29/2013] [Accepted: 12/03/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND The role of aspirin use in chemoprevention of esophageal adenocarcinoma (EAC) is still unclear. Previous meta-analyses have reported a beneficial effect of aspirin use, whereas it remains still under debate whether there are non-linear frequency-risk and duration-risk relations, such as a "threshold" effect. METHODS Nine observational studies reporting the association between aspirin use and EAC risk were selected through a combined search with the PUBMED and EMBASE electronic databases of articles published before June 2013. Overall odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using fixed-effects models, and the cubic spline regression models were performed for the study of frequency-risk and duration-risk relations. RESULTS A monotonically decreasing relation was observed only for ≤ 4.5 times per week (OR=0.75, 95%CI 0.64-0.88, for twice per week; OR=0.59, 95%CI 0.45-0.78, for 4.5 times per week) and ≤ 6 years (OR=0.82, 95%CI 0.76-0.91, for 1 year; OR=0.53, 95%CI 0.37-0.75, for 3 years) of aspirin use using the non-users as the reference. Once the frequency is more than 4.5 times/week or the duration is longer than 6 years, no further benefit was observed. CONCLUSION Our findings suggest that there may be non-linear threshold relations of frequency and duration of aspirin use with the risk of EAC. Further data from randomized clinical trials are required.
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Affiliation(s)
- Ye Xiaohua
- School of Public Health, Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China; School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China
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10
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Su Y, Lin Y, Zhang L, Liu B, Yuan W, Mo X, Wang X, Li H, Xing X, Cheng X, Dong B, Hu Y, Du H, Zhu Y, Ding N, Li J, Liu W, Ma Y, Qiu X, Ji J, Han W. CMTM3 inhibits cell migration and invasion and correlates with favorable prognosis in gastric cancer. Cancer Sci 2013; 105:26-34. [PMID: 24131472 PMCID: PMC4317871 DOI: 10.1111/cas.12304] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 10/04/2013] [Accepted: 10/10/2013] [Indexed: 12/26/2022] Open
Abstract
The CKLF-like MARVEL transmembrane domain containing 3 (CMTM3) gene is a novel tumor suppressor with frequent epigenetic inactivation. In this study, we showed the role played by CMTM3 in gastric cancer cells as a tumor suppressor gene, and examined the correlation between CMTM3 expression and clinicopathological parameters using immunohistochemistry in gastric cancer patients with different pathological stages (n = 350). We found that CMTM3 expression was reduced or silenced by epigenetic regulation in gastric cell lines, and dramatically downregulated in primary gastric cancer tissues. Restoration of CMTM3 significantly affected migration and invasion of AGS and SGC-7901 cells (P < 0.001). In vivo experiments showed that peritoneal disseminated metastases were significantly suppressed by CMTM3 (P < 0.001). We further showed that the expression of MMP2 and the phosphorylation of Erk1/2 were decreased when CMTM3 was restored. In addition, by immunohistochemical staining, we found that the expression of CMTM3 was remarkably weaker in gastric cancer tissues than in normal mucosae (P = 0.008), and was significantly correlated with gender (P = 0.033), tumor depth (P = 0.049), stage (P = 0.021), and histological grade (P = 0.022). More importantly, CMTM3 expression was associated with prognosis in gastric cancer patients (P = 0.041), and was a significant independent prognostic indicator (hazard ratio = 0.704, 95% confidence interval, 0.498–0.994; P = 0.046). Our findings indicate that CMTM3 regulates migration and invasion of gastric cancer cells. Moreover, CMTM3 is a candidate marker for prognosis of gastric cancer in the clinic.
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Affiliation(s)
- Yu Su
- Department of Immunology, School of Basic Medical Sciences, Peking University Health Science Center, Peking University Center for Human Disease Genomics, Beijing, China; Key Laboratory of Medical Immunology, Ministry of Health, Beijing, China
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11
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Myung DS, Park YL, Chung CY, Park HC, Kim JS, Cho SB, Lee WS, Lee KH, Lee JH, Joo YE. Expression of Livin in colorectal cancer and its relationship to tumor cell behavior and prognosis. PLoS One 2013; 8:e73262. [PMID: 24023847 PMCID: PMC3759411 DOI: 10.1371/journal.pone.0073262] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 07/19/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUNDS Expression of Livin, a member of the inhibitors of apoptosis protein family, is associated with tumor development and progression. The aims of this study were to evaluate whether Livin affects oncogenic biological behavior of colorectal cancer cells, and to document the relationship between its expression and various clinicopathological parameters in colorectal cancer. METHODS We investigated the impact of Livin on tumor cell behavior by using the small interfering RNA and pcDNA3.1 vector in SW480 and DKO1 colorectal cancer cell lines. The expression of Livin was investigated by RT-PCR and immunohistochemistry in coloretcal cancer tissues. The apoptotic cells were visualized by TUNEL assay, and proliferative cells were visualized by Ki-67 antibody staining. RESULTS Knockdown of Livin suppressed tumor cell migration and invasion in colorectal cancer cells. Knockdown of Livin induced the apoptosis by up-regulating of caspase-3, -7 and PARP activities and the cell cycle arrest by decreasing cyclin D1, cyclin D3, cyclin-dependent kinase 4 and 6, and by inducing p27 expression. The MAPK signaling cascades were significantly blocked by knockdown of Livin. In contrast, overexpression of Livin enhanced tumor cell migration and invasion, and inhibited the apoptosis and cell cycle arrest. The mean apoptotic index (AI) value of Livin positive tumors was significantly lower than AI of Livin negative tumors. However, there was no significant difference between Livin expression and Ki-67 labeling index (KI). Livin expression was significantly increased in colorectal cancer and metastatic lymph node tissues compared to normal colorectal mucosa and non-metastatic lymph node tissues and was associated with tumor stage, lymphovascular invasion, lymph node metastasis and poor survival. CONCLUSIONS These results indicate that Livin is associated with tumor progression by increasing tumor cell motility and inhibiting apoptosis in colorectal cancer.
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Affiliation(s)
- Dae-Seong Myung
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young-Lan Park
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Cho-Yun Chung
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyung-Chul Park
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jong-Sun Kim
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Bum Cho
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Wan-Sik Lee
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kyung-Hwa Lee
- Departments of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Hyuk Lee
- Departments of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young-Eun Joo
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
- * E-mail:
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12
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Zeng S, Tao Y, Huang J, Zhang S, Shen L, Yang H, Pei H, Zhong M, Zhang G, Liu T, Zhou M, Shen H. WD40 repeat-containing 62 overexpression as a novel indicator of poor prognosis for human gastric cancer. Eur J Cancer 2013; 49:3752-62. [PMID: 23920402 DOI: 10.1016/j.ejca.2013.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 06/18/2013] [Accepted: 07/05/2013] [Indexed: 11/24/2022]
Abstract
AIM WD40 repeat-containing 62 (WDR62) is a centrosome-associated gene involved in cell cycling and proliferation. However, the role of WDR62 in human malignancies remains unknown. The present study aimed to identify the role, if any, of WDR62 in the pathogenesis of human gastric cancer (GC). METHODS WDR62 expression in 372 cases of human GC and eight GC cell lines was determined using quantitative reverse transcription-polymerase chain reaction (qRT-PCR), immunohistochemistry and Western blotting. Correlations between WDR62 expression and clinicopathological characteristics, as well as GC prognosis were determined. WDR62 regulation of GC cell proliferation, invasion, migration and cell cycle distribution were studied both in vitro and in vivo. RESULTS WDR62 expression was significantly increased in GC tissues and cell lines and was associated with poor differentiation and prognosis of GC. WDR62 expression was elevated in GC multidrug resistant cells. Suppressing WDR62 significantly decreased cell proliferation and induced G2/M phase arrest of GC cells. Consistently, WDR62 knockdown inhibited gastric carcinogenesis in nude mice. Regulation of Akt/p38-mitogen-activated protein kinase (MAPK)/multidrug resistance gene 1 (MDR1) expression and activation by WDR62 contributed to the chemoresistance of GC cells. WDR62 overexpresses in GC and the suppression of WDR62 inhibits GC cell growth by inducing G2/M cell cycle arrest. CONCLUSION WDR62 may be a novel prognostic marker and a potential chemotherapy target for GC.
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Affiliation(s)
- Shan Zeng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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13
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Fassan M, Baffa R, Kiss A. Advanced precancerous lesions within the GI tract: the molecular background. Best Pract Res Clin Gastroenterol 2013; 27:159-69. [PMID: 23809238 DOI: 10.1016/j.bpg.2013.03.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/14/2013] [Accepted: 03/08/2013] [Indexed: 01/31/2023]
Abstract
The mainstream carcinogenic processes involved within the gastrointestinal tract are characterized by phenotypic multistep progression cascades that eventually result in full-blown cancers. In this scenario, the understanding of the molecular dysregulations underlying the precancerous lesions is increasing but still remains incomplete. However, in recent years, the enthusiastic rise of innovative technologies (i.e., next-generation sequencing, high-throughput microarray analysis, mass spectrometry based proteomics) and the unexpected discovery of new classes of biomarkers (i.e., miRNA, long-noncoding RNAs) prompted new strength in the exploration of the accurate and comprehensive molecular characterization of premalignant and malignant neoplastic lesions. The challenge ahead lies in the reliable identification of disease progression-specific targets to enable molecular testing in the clinical management of the secondary prevention of gastrointestinal cancers.
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Affiliation(s)
- Matteo Fassan
- Department of Medicine DIMED, Surgical Pathology & Cytopathology Unit, University of Padua, 35121 Padua, Italy.
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14
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GERD-Barrett-Adenocarcinoma: Do We Have Suitable Prognostic and Predictive Molecular Markers? Gastroenterol Res Pract 2013; 2013:643084. [PMID: 23573078 PMCID: PMC3615572 DOI: 10.1155/2013/643084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 02/18/2013] [Indexed: 02/07/2023] Open
Abstract
Due to unfavorable lifestyle habits (unhealthy diet and tobacco abuse) the incidence of gastroesophageal reflux disease (GERD) in western countries is increasing. The GERD-Barrett-Adenocarcinoma sequence currently lacks well-defined diagnostic, progressive, predictive, and prognostic biomarkers (i) providing an appropriate screening method identifying the presence of the disease, (ii) estimating the risk of evolving cancer, that is, the progression from Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC), (iii) predicting the response to therapy, and (iv) indicating an overall survival—prognosis for EAC patients. Based on histomorphological findings, detailed screening and therapeutic guidelines have been elaborated, although epidemiological studies could not support the postulated increasing progression rates of GERD to BE and EAC. Additionally, proposed predictive and prognostic markers are rather heterogeneous by nature, lack substantial proofs, and currently do not allow stratification of GERD patients for progression, outcome, and therapeutic effectiveness in clinical practice. The aim of this paper is to discuss the current knowledge regarding the GERD-BE-EAC sequence mainly focusing on the disputable and ambiguous status of proposed biomarkers to identify promising and reliable markers in order to provide more detailed insights into pathophysiological mechanisms and thus to improve prognostic and predictive therapeutic approaches.
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15
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Baker AM, Graham TA, Wright NA. Pre-tumour clones, periodic selection and clonal interference in the origin and progression of gastrointestinal cancer: potential for biomarker development. J Pathol 2013; 229:502-14. [PMID: 23288692 DOI: 10.1002/path.4157] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 12/17/2012] [Accepted: 12/18/2012] [Indexed: 12/18/2022]
Abstract
Classically, the risk of cancer progression in premalignant conditions of the gastrointestinal tract is assessed by examining the degree of histological dysplasia. However, there are many putative pro-cancer genetic changes that have occurred in histologically normal tissue well before the onset of dysplasia. Here we summarize the evidence for such pre-tumour clones and the existing technology that can be used to locate these clones and characterize them at the genetic level. We also discuss the mechanisms by which pre-tumour clones may spread through large areas of normal tissue, and highlight emerging theories on how multiple clones compete and interact within the gastrointestinal mucosa. It is important to gain an understanding of these processes, as it is envisaged that certain pre-tumour changes may be powerful predictive markers, with the potential to identify patients at high risk of developing cancer at a much earlier stage.
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Affiliation(s)
- Ann-Marie Baker
- Centre for Tumour Biology, Barts and the London School of Medicine and Dentistry, London, UK.
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16
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Abstract
Barrett's esophagus (BE) is a common lesion that predisposes to a highly fatal esophageal adenocarcinoma (EA). There is evidence that BE or parts of its phenotype are genetically predisposed. Several single-nucleotide polymorphisms (SNPs) have been validated as predisposing to BE but the inherent flaws in the trial sizes, presence of controls and statistical power need circumspect analysis. The current paper links the interleukin 18 cytokine with BE and perhaps EA. Setting aside the issues above there are other issues such as the functional relevance of these SNPs for the association BE. There have been several case control series published indicating other genes. Furthermore, there are some sibling pairs study results with another set of genes identified. Invariably as useful as these studies are the size, scale to answer complex questions (complexity) and potential clinical significance are proportional in genomic studies. The new era of large-scale genome-wide studies in Barrett's and EA is needed. Shortly the first will be published showing two SNPs of significance in 7,838 Barrett's patients.
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17
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Patnaik SK, Mallick R, Yendamuri S. MicroRNAs and esophageal cancer. J Gastrointest Oncol 2012; 1:55-63. [PMID: 22811805 DOI: 10.3978/j.issn.2078-6891.2010.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 09/09/2010] [Indexed: 12/17/2022] Open
Abstract
Cancer of the esophagus is a highly aggressive disease associated with an overall poor prognosis. There is an insistent need for improving our understanding of the molecular basis of this disease. The recent emergence of observations on the role of microRNAs in cancer and their potential as biomarkers has prompted many investigations to examine their relevance to esophageal cancer. This article provides an introduction to microRNA biology and the techniques involved in studying them, and summates what is now known about their role and utility in regard to neoplastic esophageal diseases.
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Affiliation(s)
- Santosh Kumar Patnaik
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA
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18
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Wang P, Wang YC, Chen XY, Shen ZY, Cao H, Zhang YJ, Yu J, Zhu JD, Lu YY, Fang JY. CTHRC1 is upregulated by promoter demethylation and transforming growth factor-β1 and may be associated with metastasis in human gastric cancer. Cancer Sci 2012; 103:1327-33. [PMID: 22590977 DOI: 10.1111/j.1349-7006.2012.02292.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/19/2012] [Accepted: 03/26/2012] [Indexed: 12/14/2022] Open
Abstract
The gene, collagen triple helix repeat containing 1 (CTHRC1), has been reported to increase in several kinds of human solid cancers and is associated with tumor invasion and metastasis. To date, the expression and function of CTHRC1 in gastric cancer (GC) have not been reported. The aim of this study was to investigate the expression levels and regulatory transcription mechanisms of CTHRC1 in GC. Immunohistochemical analysis revealed that CTHRC1 expression was markedly increased in carcinoma compared with normal gastric mucosa, chronic atrophic gastritis, and intestinal metaplasia (P < 0.05 for all), and this overexpression in tumor was related to depth of tumor invasion. Moreover, RNA interference-mediated knockdown and ectopic expression of CTHRC1 showed that CTHRC1 promoted tumor cell invasion in vitro. We then investigated the mechanisms underlying the aberrant expression of CTHRC1 in GC and found that CTHRC1 expression was restored after GC cell lines were treated with the demethylating agent, 5-aza-2'-deoxycytidine. Transforming growth factor-β1 led to an increase in levels of CTHRC1 mRNA and protein. Overall, our data revealed that the upregulated expression of CTHRC1 in gastric carcinogenesis contributes to tumor cell invasion and metastasis, and promoter demethylation and transforming growth factor-β1 may co-regulate the expression of CTHRC1.
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Affiliation(s)
- Ping Wang
- Gastrointestinal Division, Shanghai Jiaotong University School of Medicine Renji Hospital, Shanghai Institute of Digestive Diseases, Shanghai
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19
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Kosoff RE, Gardiner KL, Merlo LMF, Pavlov K, Rustgi AK, Maley CC. Development and characterization of an organotypic model of Barrett's esophagus. J Cell Physiol 2012; 227:2654-9. [PMID: 21882191 DOI: 10.1002/jcp.23007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Understanding the molecular and cellular processes underlying the development, maintenance, and progression of Barrett's esophagus (BE) presents an empirical challenge because there are no simple animal models and standard 2D cell culture can distort cellular processes. Here we describe a three-dimensional (3D) cell culture system to study BE. BE cell lines (CP-A, CP-B, CP-C, and CP-D) and esophageal squamous keratinocytes (EPC2) were cultured on a matrix consisting of esophageal fibroblasts and collagen. Comparison of growth and cytokeratin expression in the presence of all-trans retinoic acid or hydrochloric acid was made by immunohistochemistry and Alcian Blue staining to determine which treatments produced a BE phenotype of columnar cytokeratin expression in 3D culture. All-trans retinoic acid differentially affected the growth of BE cell lines in 3D culture. Notably, the non-dyplastic metaplasia-derived cell line (CP-A) expressed reduced squamous cytokeratins and enhanced columnar cytokeratins upon ATRA treatment. ATRA altered the EPC2 squamous cytokeratin profile towards a more columnar expression pattern. Cell lines derived from patients with high-grade dysplasia already expressed columnar cytokeratins and therefore did not show a systematic shift toward a more columnar phenotype with ATRA treatment. ATRA treatment, however, did reduce the squamoid-like multilayer stratification observed in all cell lines. As the first study to demonstrate long-term 3D growth of BE cell lines, we have determined that BE cells can be cultured for at least 3 weeks on a fibroblast/collagen matrix and that the use of ATRA causes a general reduction in squamous-like multilayered growth and an increase in columnar phenotype with the specific effects cell-line dependent.
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Affiliation(s)
- Rachelle E Kosoff
- Cancer Biology Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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20
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Kaz AM, Grady WM. Epigenetic biomarkers in esophageal cancer. Cancer Lett 2012; 342:193-9. [PMID: 22406828 DOI: 10.1016/j.canlet.2012.02.036] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 02/25/2012] [Accepted: 02/29/2012] [Indexed: 12/13/2022]
Abstract
The aberrant DNA methylation of tumor suppressor genes is well documented in esophageal cancer, including adenocarcinoma (EAC) and squamous cell carcinoma (ESCC) as well as in Barrett's esophagus (BE), a pre-malignant condition that is associated with chronic acid reflux. BE is a well-recognized risk factor for the development of EAC, and consequently the standard of care is for individuals with BE to be placed in endoscopic surveillance programs aimed at detecting early histologic changes that associate with an increased risk of developing EAC. Yet because the absolute risk of EAC in individuals with BE is minimal, a clinical need in the management of BE is the identification of additional risk markers that will indicate individuals who are at a significant absolute risk of EAC so that they may be subjected to more intensive surveillance. The best currently available risk marker is the degree of dysplasia in endoscopic biopsies from the esophagus; however, this marker is suboptimal for a variety of reasons. To date, there are no molecular biomarkers that have been translated to widespread clinical practice. The search for biomarkers, including hypermethylated genes, for either the diagnosis of BE, EAC, or ESCC or for risk stratification for the development of EAC in those with BE is currently an area of active research. In this review, we summarize the status of identified candidate epigenetic biomarkers for BE, EAC, and ESCC. Most of these aberrantly methylated genes have been described in the context of early detection or diagnostic markers; others might prove useful for estimating prognosis or predicting response to treatment. Finally, special attention will be paid to some of the challenges that must be overcome in order to develop clinically useful esophageal cancer biomarkers.
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Affiliation(s)
- Andrew M Kaz
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, United States; Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States; Research and Development Service, VA Puget Sound Health Care System, Seattle, WA, United States.
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21
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Anderson N, Suliman I, Bandaletova T, Obichere A, Lywood R, Loktionov A. Protein biomarkers in exfoliated cells collected from the human rectal mucosa: implications for colorectal disease detection and monitoring. Int J Colorectal Dis 2011; 26:1287-97. [PMID: 21698353 DOI: 10.1007/s00384-011-1263-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2011] [Indexed: 02/04/2023]
Abstract
PURPOSE Colorectal disease biomarkers in stool are actively explored, but instability of biomolecules in faeces constitutes a problem. Collection of exfoliated cells from the surface of the rectal mucosa provides an alternative to stool-based methods. We aimed to develop an original approach allowing preservation and quantification of protein biomarkers in exfoliated material and tested it in a pilot clinical study. METHODS A novel method of cell and protein preservation in ammonium sulphate-rich buffers was developed using cultured human cells and applied to exfoliated cell samples collected from 139 faecal occult blood test (FOBT)-positive patients prior to colonoscopies. Protein biomarkers comprising calprotectin, eosinophil-derived neurotoxin (EDN), dimeric pyruvate kinase type M2 (M2PK), soluble cytokeratin-18, d-dimer and glyceraldehyde 3-phosphate dehydrogenase were quantified using enzyme-linked immunosorbent assays with parallel cytological and immunocytochemical analysis. RESULTS Long-term preservation of cells and their protein constituents at ambient temperature was achieved using buffers containing saturated ammonium sulphate. Application of this approach to exfoliated cell samples allowed consistent protein quantification. Calprotectin, EDN, M2PK, soluble cytokeratin 18 and d-dimer showed dramatic increase in a few cases of inflammatory bowel disease (IBD) detected among trial participants. Cytological signs of inflammation were also present in these samples. CONCLUSIONS Application of exfoliated cells collected from the surface of the rectal mucosa provides a reliable method for quantifying protein biomarkers of gastrointestinal diseases. Our preliminary results obtained in a limited number of cases indicate that the approach might be especially useful for IBD diagnosis and monitoring, but further studies are needed to assess its diagnostic value.
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Abstract
Barrett's esophagus is an acquired metaplastic abnormality in which the normal stratified squamous epithelium lining of the esophagus is replaced by an intestinal-like columnar epithelium. While in itself a benign and asymptomatic disorder, the clinical importance of this relatively common condition relates to its role as a precursor lesion to esophageal adenocarcinoma, the incidence of which has dramatically increased in Western populations in recent years. Although known to arise as a consequence of chronic gastroesophageal reflux, the cellular and molecular mechanisms underlying development Barrett's esophagus and its progression to cancer remain unclear.
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Affiliation(s)
- Wayne A Phillips
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
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PDCD4 nuclear loss inversely correlates with miR-21 levels in colon carcinogenesis. Virchows Arch 2011; 458:413-9. [PMID: 21279518 DOI: 10.1007/s00428-011-1046-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 01/08/2011] [Accepted: 01/11/2011] [Indexed: 01/02/2023]
Abstract
Programmed cell death 4 (PDCD4) has recently been demonstrated to be a new tumor suppressor gene involved in colon carcinogenesis. PDCD4 immunohistochemical expression was assessed in 300 polypoid lesions of the colon mucosa (50 hyperplastic polyps [HP], 50 serrated adenomas [SA], 50 tubular adenomas with low-grade-intraepithelial neoplasia [LG-IEN], 50 tubular adenomas with high-grade-IEN [HG-IEN]), and in 50 colon adenocarcinomas (CRC). As normal controls, we considered 50 biopsy samples obtained from patients with irritable bowel syndrome (N). We further investigated PDCD4 messenger RNA (mRNA) levels by quantitative real-time polymerase chain reaction (PCR) in a different series of N, LG-IEN, HG-IEN, and CRC biopsy samples. miR-21 expression (an important PDCD4-expression regulator) was also determined by quantitative real-time PCR and in situ hybridization. Normal colocytes and HP featured strong PDCD4 nuclear immunostaining whereas a significantly lower PDCD4 nuclear expression was observed in dysplasia (low- and high-grade adenomas and SA) and invasive CRC. PDCD4 immunostaining and mRNA levels decreased significantly as the phenotypic changes occurring during colon carcinogenesis progressively increased (p < 0.001). As expected, miR-21 expression was significantly upregulated in preneoplastic/neoplastic samples, consistent with PDCD4 downregulation. These results consistently support the use of nuclear PDCD4 immunohistochemical downregulation as a novel biomarker for the diagnosis of dysplastic/neoplastic lesions in colon biopsy samples.
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Fan J, Yan D, Teng M, Tang H, Zhou C, Wang X, Li D, Qiu G, Peng Z. Digital Transcript Profile Analysis with aRNA-LongSAGE Validates FERMT1 As a Potential Novel Prognostic Marker for Colon Cancer. Clin Cancer Res 2011; 17:2908-18. [PMID: 21220475 DOI: 10.1158/1078-0432.ccr-10-2552] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Junwei Fan
- Department of General Surgery, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, China
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Dent J. Barrett's esophagus: A historical perspective, an update on core practicalities and predictions on future evolutions of management. J Gastroenterol Hepatol 2011; 26 Suppl 1:11-30. [PMID: 21199510 DOI: 10.1111/j.1440-1746.2010.06535.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Interpretation of exploding knowledge about Barrett's esophagus is impaired by use of several conflicting definitions. Because any histological type of esophageal columnar metaplasia carries risk for esophageal adenocarcinoma, the diagnosis of Barrett's esophagus should no longer require demonstration of intestinal-type metaplasia. Endoscopic recognition and grading of Barrett's esophagus remains a significant source of ambiguity. Reflux disease is a key factor for development of Barrett's esophagus, but other factors must underlie its development, since it occurs in only a minority of reflux disease patients. Neither antireflux surgery nor proton pump inhibitor (PPI) therapy has major impacts on cancer risk. Within a year, a major trial should indicate whether low-dose aspirin usefully reduces cancer risk. The best referral centers have transformed the accuracy of screening and surveillance for early curable esophageal adenocarcinoma by use of enhanced and novel endoscopic imaging, visually-guided, rather than blind biopsies and by partnership with expert pathologists. General endoscopists now need to upgrade their skills and equipment so that they can rely mainly on visual targeting of biopsies on mucosal areas of concern in their surveillance practice. General pathologists need to greatly improve their interpretation of biopsies. Endoscopic therapy now achieves very high rates of cure of high-grade dysplasia and esophageal adenocarcinoma with minimal morbidity and risk. Such results will only be achieved by skilled interventional endoscopists. Esophagectomy should now be mainly restricted to patients whose cancer has extended into and beyond the submucosa. Weighing risks and benefits in the management of Barrett's esophagus is difficult, as is the process of adequately informing patients about their specific cancer risk.
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Affiliation(s)
- John Dent
- Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, University of Adelaide, South Australia, Australia.
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Muthusamy VR, Sharma P. Diagnosis and management of Barrett's esophagus: What's next? Gastrointest Endosc Clin N Am 2011; 21:171-81. [PMID: 21112506 DOI: 10.1016/j.giec.2010.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The past decade has led to marked improvements in our understanding regarding the pathogenesis and risk of progression of Barrett's esophagus (BE), enhanced imaging technology to improve dysplasia detection, and the development and refinement of endoscopic techniques, such as mucosal ablation and endoscopic mucosal resection(EMR), to eradicate BE. However, many questions remain including identifying which, if any, candidates are most appropriate for screening for BE; how to improve current surveillance protocols; predicting which patients with BE will develop neoplastic progression; identifying the most appropriate candidates for endoscopic eradication therapy; developing algorithms for appropriate management posteradication; and understanding the potential role of chemoprophylaxis. This article describes potential future advances regarding screening, surveillance, risk stratification, endoscopic eradication therapies, and chemoprevention and provides a potential future management strategy for patients with BE.
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Affiliation(s)
- V Raman Muthusamy
- Division of Gastroenterology, University of California, 101 The City Drive, City Tower, Suite 400, Zot 4092, Irvine, Orange, CA 92868, USA
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Ong CAJ, Lao-Sirieix P, Fitzgerald RC. Biomarkers in Barrett’s esophagus and esophageal adenocarcinoma: Predictors of progression and prognosis. World J Gastroenterol 2010; 16:5669-81. [PMID: 21128316 PMCID: PMC2997982 DOI: 10.3748/wjg.v16.i45.5669] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per annum) of progression to esophageal adenocarcinoma (EA), which has a poor outcome unless diagnosed early. The current clinical management of Barrett’s esophagus is hampered by the lack of accurate predictors of progression. In addition, when patients develop EA, the current staging modalities are limited in stratifying patients into different prognostic groups in order to guide the optimal therapy for an individual patient. Biomarkers have the potential to improve radically the clinical management of patients with Barrett’s esophagus and EA but have not yet entered mainstream clinical practice. This is in contrast to other cancers like breast and prostate for which biomarkers are utilized routinely to inform clinical decisions. This review aims to highlight the most promising predictive and prognostic biomarkers in Barrett’s esophagus and EA and to discuss what is required to move the field forward towards clinical application.
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Atreya R, Waldner MJ, Neurath MF. Molecular imaging: interaction between basic and clinical science. Gastroenterol Clin North Am 2010; 39:911-22. [PMID: 21093763 DOI: 10.1016/j.gtc.2010.08.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
One of the major proceedings in the field of gastrointestinal endoscopy has been the advent of molecular imaging, which possesses the potential to have a significant effect on the existing diagnostic and therapeutic paradigms. Molecular imaging encompasses different methods that enable the visualization of disease-specific morphologic or functional alterations of the mucosa based on the molecular signature of individual cells. This development has been made possible by advancements in basic science coupled with technological innovations in endoscopy, both facilitating the identification and characterization of mucosal lesions in vivo based on the lesions' molecular composition rather than their morphologic structure alone. Novel studies based on fluorescent antibody imaging pave the road toward clinical translation and give hope for improved diagnosis and targeted therapies in gastrointestinal diseases.
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Affiliation(s)
- Raja Atreya
- Medical Clinic I, University of Erlangen-Nuremberg, Ulmenweg 18, 91056 Erlangen, Germany
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Wang P, Tang JT, Peng YS, Chen XY, Zhang YJ, Fang JY. XRCC1 downregulated through promoter hypermethylation is involved in human gastric carcinogenesis. J Dig Dis 2010; 11:343-51. [PMID: 21091896 DOI: 10.1111/j.1751-2980.2010.00459.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To analyze the expression and aberrant methylation of X-ray repair cross-complementing gene 1 (XRCC1) in gastric carcinogenesis, and identify the molecular mechanism of gastric carcinogenesis. METHODS The method based on methyl binding domain protein (MBD) immuno-precipitation and promoter microarray was employed to screen the gastric cancer-related methylation-sensitive gene. An immunohistochemistry assay was applied to detect the protein expression of XRCC1 in the multistep progression of gastric carcinogenesis. The mRNA expression of XRCC1 was determined by real-time PCR in tumor tissues and their corresponding non-tumorous tissues. The methylation status and Arg194Trp and Arg399Gln polymorphisms of XRCC1 in gastric cancer and gastritis tissues were analyzed by methylation-specific PCR, bisulfite genomic sequencing and direct DNA sequencing, respectively. RESULTS Promoter microarray screening and identification suggested that XRCC1 was a methylation-sensitive gene. Immunochemistry results showed that XRCC1 protein expression gradually decreased with progression of gastric mucosal lesions (P < 0.05). The positive rate of XRCC1 in patients with well/moderately differentiated gastric cancer was significantly higher than patients with poorly differentiated gastric cancer (P < 0.05). The mRNA expression of XRCC1 in gastric cancer tissues was significantly lower than that in the non-tumorous tissues (P < 0.05). Meanwhile, XRCC1 methylation in gastric cancer tissues was more frequent than that in the gastritis tissues (P < 0.05), and the downregulation of XRCC1 expression was relevant to methylation (P < 0.05). CONCLUSION The expression of XRCC1 is downregulated in gastric carcinogenesis, and promoter hypermethylation may be one of the mechanisms contributing to its downregulation.
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Affiliation(s)
- Ping Wang
- Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
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Melton SD, Genta RM, Souza RF. Biomarkers and molecular diagnosis of gastrointestinal and pancreatic neoplasms. Nat Rev Gastroenterol Hepatol 2010; 7:620-8. [PMID: 20924366 PMCID: PMC3197699 DOI: 10.1038/nrgastro.2010.153] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Standard protocols for the diagnosis of neoplasms in the gastrointestinal tract are based on histopathologic analysis in combination with clinical information. With the completion of the Human Genome Project in 2003, our understanding of the contribution of genetics to human disease has increased exponentially. This knowledge is gradually being incorporated into clinical decision-making. However, the rate at which molecular biomarkers are validated for use in mainstream clinical applications has lagged far behind that of biomarker discovery. Nevertheless, a number of molecular biomarkers are available for use in the diagnosis and management of gastrointestinal tract neoplasms. This article reviews the most common molecular biomarkers currently available for neoplasms of the luminal gastrointestinal tract and pancreas. In neoplasms of the esophagus, for which no biomarkers are currently used in routine clinical practice, those that have shown the most promise in early clinical validation studies are discussed.
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Affiliation(s)
- Shelby D. Melton
- Departments of Pathology and Laboratory Medicine, University of Texas Southwestern Medical Center, Dallas, TX, VA North Texas Health Care System, University of Texas Southwestern Medical Center, Dallas, TX
| | - Robert M. Genta
- Departments of Pathology and Laboratory Medicine, University of Texas Southwestern Medical Center, Dallas, TX, VA North Texas Health Care System, University of Texas Southwestern Medical Center, Dallas, TX, Caris Research Institute, Irving, TX
| | - Rhonda F. Souza
- Department of Medicine, VA North Texas Health Care System & University of Texas Southwestern Medical Center, Dallas, TX, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
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Prasad GA, Bansal A, Sharma P, Wang KK. Predictors of progression in Barrett's esophagus: current knowledge and future directions. Am J Gastroenterol 2010; 105:1490-1502. [PMID: 20104216 PMCID: PMC3408387 DOI: 10.1038/ajg.2010.2] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Barrett's esophagus (BE) is the strongest risk factor for esophageal adenocarcinoma (EAC), a malignancy with persistently poor long-term outcomes. EAC is thought to develop through progression of metaplasia to dysplasia to invasive carcinoma. Identification of factors predicting progression to EAC would help in focusing surveillance, chemoprevention, or ablation for those deemed to be at highest risk of progression. We performed a comprehensive review of the literature and summarized current evidence on risk factors for progression in subjects with known BE. Clinical and demographic factors (age, male gender, length of BE segment) are associated with modestly increased odds of progression to EAC in some studies. Biomarkers such as aneuploidy and p53 loss of heterozygosity have been associated with increased risk of progression to high-grade dysplasia and/or EAC in single-center prospective cohort studies. Promising newer techniques and markers have been recently reported with the potential to help risk stratify BE subjects. Development of a comprehensive BE risk progression score comprised of both clinical and biomarker variables should be the ultimate goal and can be achieved by multicenter prospective collaborative efforts. Although it would be challenging, creation of such a score has the potential to improve outcomes and make the management of patients with BE more cost-effective.
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Affiliation(s)
- Ganapathy A. Prasad
- Division of Gastroenterology and Hepatology, Barrett’s Esophagus Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Ajay Bansal
- Division of Gastroenterology, Veterans Affairs Medical Center & University of Kansas School of Medicine, Kansas City, Missouri, USA.
| | - Prateek Sharma
- Division of Gastroenterology, Veterans Affairs Medical Center & University of Kansas School of Medicine, Kansas City, Missouri, USA.
| | - Kenneth K. Wang
- Division of Gastroenterology and Hepatology, Barrett’s Esophagus Unit, Mayo Clinic, Rochester, Minnesota, USA
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Link A, Balaguer F, Shen Y, Nagasaka T, Lozano JJ, Boland CR, Goel A. Fecal MicroRNAs as novel biomarkers for colon cancer screening. Cancer Epidemiol Biomarkers Prev 2010; 19:1766-74. [PMID: 20551304 DOI: 10.1158/1055-9965.epi-10-0027] [Citation(s) in RCA: 242] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) is the second leading cause of cancer-related deaths, but currently available noninvasive screening programs have achieved only a modest decrease in mortality. MicroRNAs (miRNA) play an important role in a wide array of biological processes and are commonly dysregulated in neoplasia. We aimed to evaluate the feasibility of fecal miRNAs as biomarkers for colorectal neoplasia screening. MATERIALS AND METHODS Total RNA was extracted from freshly collected stool samples from 8 healthy volunteers and 29 samples collected via fecal occult blood testing from subjects with normal colonoscopies, colon adenomas, and CRCs. miRNA expression analyses were done with TaqMan quantitative reverse transcription-PCR for a subset of miRNAs. Illumina miRNA microarray profiling was done to evaluate the differences in expression patterns between normal colonic mucosa tissues and stool samples from healthy subjects. RESULTS We efficiently extracted miRNAs from stool specimens using our developed protocol. Data from independent experiments showed high reproducibility for miRNA extraction and expression. miRNA expression patterns were similar in stool specimens among healthy volunteers, and reproducible in stool samples that were collected serially in time from the same individuals. miRNA expression profiles from 29 patients showed higher expression of miR-21 and miR-106a in patients with adenomas and CRCs compared with individuals free of colorectal neoplasia. CONCLUSION Our data indicate that miRNAs could be extracted from stool easily and reproducibly. The stools of patients with colorectal neoplasms have unique and identifiable patterns of miRNA expression. IMPACT Fecal miRNAs may be an excellent candidate for the development of a noninvasive screening test for colorectal neoplasms.
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Affiliation(s)
- Alexander Link
- Gastrointestinal Cancer Research Laboratory, Baylor University Medical Center, Dallas, TX 75246, USA
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34
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Abstract
Biomarkers are needed to screen multiple stages in the clinical pathway of Barrett's oesophagus patients; from disease diagnosis to risk stratification and predicting response to therapy. Routes to the identification of biomarkers have been recognized by known molecular features of the disease and more recently through transcriptomic, methylation and proteomic screening approaches. The majority of Barrett's oesophagus patients remain undiagnosed in the general population. In order to develop a tool to screen for Barrett's oesophagus in the primary care setting, minimally invasive sampling methods coupled with immunocytology-based biomarkers are currently being assessed. Biomarkers may also have utility in surveillance programmes by allowing endoscopic interval to be adjusted according to individual neoplastic risk. Many individual biomarkers have been proposed in this regard, but have frequently been assessed in studies of limited power, or have lacked sufficient sensitivity or specificity when assessed in wider population-based studies. Biomarker panels may provide a route forward. In this regard, a panel of methylation markers has shown promise in a multicentre, double-blind, validation study. Biomarkers are also being developed to improve detection of high-grade dysplasia and oesophageal adenocarcinoma, utilizing brush cytology combined with FISH (fluorescence in situ hybridization), and to assess therapeutic success and risk of complication during photodynamic therapy. Finally, we outline progress in identifying alternative sources of biomarkers for this condition.
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35
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Carneiro F. Molecular pathology tools in gastrointestinal pathology. Int J Surg Pathol 2010; 18:53S-55S. [PMID: 20484262 DOI: 10.1177/1066896910368593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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36
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Weimann A, Zimmermann M, Gross M, Slevogt H, Rieger A, Morawietz L. CDX2 and LI-cadherin expression in esophageal mucosa: use of both markers can facilitate the histologic diagnosis of Barrett's esophagus and carcinoma. Int J Surg Pathol 2010; 18:330-7. [PMID: 20444732 DOI: 10.1177/1066896910364228] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Barrett's mucosa is a risk factor for esophageal adenocarcinoma and should be detected at an early stage. CDX2 and liver-intestine (LI)-cadherin are intestine-specific markers. Aberrant CDX2 expression has been demonstrated in Barrett's metaplasia, esophagitis, and intestinal metaplasia of the stomach. METHODS The relationship between CDX2 and LI-cadherin expression was investigated in normal gastroesophageal (n = 24) and in Barrett's (n = 20) mucosa, in low-grade (n = 15) and high-grade (n = 13) intraepithelial neoplasia (IEN) as well as in esophageal adenocarcinoma (n = 16), using immunohistochemistry. RESULTS Nuclear positivity for CDX2 coupled with membranous expression of LI-cadherin was observed in about 70% of the epithelial cells of Barrett's mucosa. The intensity of staining and the percentage of positive cells increased within the sequential steps of low-grade to high-grade IEN, whereas the normal cylindric epithelium lacked the expression of both. In adenocarcinoma, the expression of LI-cadherin and CDX2 was significantly weaker or absent. CONCLUSIONS CDX2 and LI-cadherin are sensitive markers of intestinal metaplasia with or without dysplasia in the upper gastrointestinal tract. Both can be helpful for the early histologic diagnosis of Barrett's esophagus and its subsequent lesions; however, they do not significantly discern between different grades of dysplasia.
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37
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Knüchel-Clarke R, Lutz HH, Floege J, Marx N, Brümmendorf TH, Trautwein C. [When only the pathologist may help. Limitation and possibilities of biopsies in Internal Medicine]. Internist (Berl) 2010; 51:463-72. [PMID: 20195562 DOI: 10.1007/s00108-009-2453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Histological evaluation after biopsy remains the gold standard for the diagnosis of numerous diseases in Internal Medicine. The gastrointestinal tract (e. g. esophagus, liver and large intestine), the kidneys or bone marrow are organs, where biopsy-driven diagnosis and evaluation of therapeutic regimens are of major relevance. Improvement in blood analysis, endoscopic techniques and radiology could significantly reduce the number of biopsies. Hence under certain circumstances, the risk of biopsy can be avoided and non-invasive markers can sufficiently substitute the histological evaluation. However, histological evaluation derived from biopsies remains the standard of diagnosis in many cases in Internal Medicine. In the present review the current standards and future developments of pathologic diagnosis through biopsy are illustrated.
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Affiliation(s)
- R Knüchel-Clarke
- Institut für Pathologie, Medizinische Fakultät der RWTH Aachen, Pauwelsstrasse 30, 52072 Aachen.
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Power DG, Ilson DH. Integration of targeted agents in the neo-adjuvant treatment of gastro-esophageal cancers. Ther Adv Med Oncol 2009; 1:145-65. [PMID: 21789119 PMCID: PMC3126001 DOI: 10.1177/1758834009347323] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Pre- and peri-operative strategies are becoming standard for the management of localized gastro-esophageal cancer. For localized gastric/gastro-esophageal junction (GEJ) cancer there are conflicting data that a peri-operative approach with cisplatin-based chemotherapy improves survival, with the benefits seen in esophageal cancer likely less than a 5-10% incremental improvement. Further trends toward improvement in local control and survival, when combined chemotherapy and radiation therapy are given pre-operatively, are suggested by recent phase III trials. In fit patients, a significant survival benefit with pre-operative chemoradiation is seen in those patients who achieve a pathologic complete response. In esophageal/GEJ cancer, definitive chemoradiation is now considered in medically inoperable patients. In squamous cell carcinoma of the esophagus, surgery after primary chemoradiation is not clearly associated with an improved overall survival, however, local control may be better. In localized gastric/GEJ cancer, the integration of bevacizumab with pre-operative chemotherapy is being explored in large randomized studies, and with chemoradiotherapy in pilot trials. The addition of anti-epidermal growth factor receptor and anti-human epidermal growth factor receptor-2 antibody treatment to pre-operative chemoradiation continues to be explored. Early results show the integration of targeted therapy is feasible. Metabolic imaging can predict early response to pre-operative chemotherapy and biomarkers may further predict response to pre-operative chemo-targeted therapy. A multimodality approach to localized gastro-esophageal cancer has resulted in better outcomes. For T3 or node-positive disease, surgery alone is no longer considered appropriate and neo-adjuvant therapy is recommended. The future of neo-adjuvant strategies in this disease will involve the individualization of therapy with the integration of molecular signatures, targeted therapy, metabolic imaging and predictive biomarkers.
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Affiliation(s)
- D G Power
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065
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Pucci S, Bonanno E, Sesti F, Mazzarelli P, Mauriello A, Ricci F, Zoccai GB, Rulli F, Galatà G, Spagnoli LG. Clusterin in stool: a new biomarker for colon cancer screening? Am J Gastroenterol 2009; 104:2807-15. [PMID: 19623170 DOI: 10.1038/ajg.2009.412] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The identification of useful markers for early diagnosis of human colon cancer is a major goal still in progress. Clusterin is a pleiotropic protein with a broad range of functions. It has recently drawn much attention because of its association with cancer promotion and metastasis. It is involved in prosurvival and apoptosis processes that are carried out by two different isoforms. Secreted clusterin isoform (sCLU) is cytoprotective and its prosurvival function is the basis of the current phase I/II clinical trials against prostate, lung, and breast cancers. We have already shown that in colorectal cancer (CRC) there is an increased expression of sCLU. In this report, we investigated whether sCLU is released in the blood and stool of colon cancer patients in order to study sCLU as a potential diagnostic molecular marker for colon cancer screening. METHODS The quantitative expression of sCLU was determined by dot blot immunodosage in the serum and stool of CRC patients (n=63) and age-matched controls without clinical history of neoplasia, CRC, or systemic or bowel inflammatory disease (n=50). Unpaired t-tests and Mann-Whitney U-tests were used for continuous variables. The diagnostic performance of clusterin was appraised by means of receiver operating characteristic (ROC) curves. RESULTS We found a significant increase of sCLU in the serum and stool of CRC patients (P=0.0002 and P<0.000, respectively) as compared with controls. ROC curves provided cutoff points showing a trade-off between sensitivity and specificity. With a cutoff point of 88.5 microg/ml, sCLU in blood showed a 55.6% sensitivity and 100% specificity, and with a cutoff point of 34.6 microg/g, the stool test reached 66.7% sensitivity and 84% specificity in discriminating between nonneoplastic and colorectal neoplastic lesions. Human cancer xenografts in nude mice indicated a positive correlation between increasing serum clusterin level and tumor size. CONCLUSIONS This study highlights the potential of clusterin detection in stool to be a valuable tool to improve the effectiveness and efficiency of large-scale clinical cancer screening.
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Affiliation(s)
- Sabina Pucci
- Department of Biopathology, University of Rome Tor Vergata, Rome, Italy.
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41
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Abstract
There are 5 to 6 levels of biomarker validation. Those for Barrett's esophagus are currently at level 3, despite small prospective studies. What is ideally required is a very large prospective assessment of biopsies in large cohorts, such as the ASPirin Esomeprazole Chemoprevention Trial (AspECT) and Barrett's Oesophagus Surveillance Study (BOSS) trials, so that unbiased and random selection of cases can be subjected to rigorous pathology and biomarker assessment (level 4). Only then can the predictive power of the data be exploited in a randomized intervention trial (level 5) whereby a series of biomarkers would trigger therapy. The real trouble is that this spot is currently occupied, satisfactorily according to some researchers, by conventional histological identification of high-grade dysplasia (HGD) as used in a recent randomized study of ablation in Barrett's esophagus (BE).
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Fléjou JF, Cervera P. [Pathology: on the way to molecular analysis]. ACTA ACUST UNITED AC 2009; 33:767-74. [PMID: 19692190 DOI: 10.1016/j.gcb.2009.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
For a long time, pathology has been playing an important role in digestive diseases, especially in digestive cancers. This contribution was based and is still based on classical morphological techniques: staining of cells and tissues and recognition of diagnostic morphological patterns characteristic for a disease. Pathology is changing, and accompanies major improvements in endoscopy and imaging of gastrointestinal diseases, and new high throughput biological techniques. Recent examples show that molecular pathology (including immunohistochemistry), often included in wider "biopathology" processes, participates to pathophysiological research (for example recognition of the serrated pathway in colorectal carcinogenesis and its relation with microsatellite instability and methylation of promoters), and to diagnostic and therapeutic procedures (for example targeted therapies of gastrointestinal stromal tumours). However, the current example of the recognition of predictive factors of response to anti-EGFR treatments in colorectal cancer shows that morphological and non morphological techniques have to find their respective role in this kind of process.
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Affiliation(s)
- J-F Fléjou
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Saint-Antoine, AP-HP, Faculté de Médecine Pierre-et-Marie-Curie, 75012, Paris, France.
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